Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2018032441 | MO |
N | 111NI0900X | Internist | 2018032441 | MO |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2018032441 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 2018032441 | MO |
NPI | 1740523547 |
---|---|
Provider Name | Dr. Amanda Kristina Verma |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63141-6666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200064694 | (05) | MO |